Medcom Health Services, LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

MEDCOM HEALTH SERVICES, LLC

Practice address

258 N New Rd
Pleasantville, NJ 08232-2170

Phone

(609) 646-4064

NPI assigned

Sep 24, 2008

Organization subpart

Yes

Parent organization

MEDCOM HEALTH SERVICES, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ilyas Rajput, MD

Title

Owner

Phone

(609) 646-4064

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Medcom Health Services PA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jancy Civichan

  • Adult Health Nurse Practitioner
  • Pleasantville, NJ
  • NPI 1952897829
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1881844041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 N NEW RD",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322170",
            "telephone_number": "609-646-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 N NEW RD",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322170",
            "telephone_number": "609-646-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCOM HEALTH SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDCOM HEALTH SERVICES, LLC",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "RAJPUT",
        "authorized_official_first_name": "ILYAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-646-4064",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6237002",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Luna, PHARMD
• Mainland Dental Associates
• Janay Martin
• Teresa Martone, APN
• Amber McKnight
• Medexcel LLC
• Erik Mendelsohn, DMD
• Ira Mendelsohn, DDS
• Kwame Mensah
• Mercylife NJ Limited Liability Company

• Cardiovascular Disease Physician in Pleasantville, NJ
• Providers in Pleasantville, NJ by specialty
• Cardiovascular Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.